Imaging
Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.
The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.
Medical Image of the Week: Esophageal-Pleural Fistula
Figure 1. Esophagram showing fistulous tract formation from the distal esophagus just proximal to the gastroesophageal junction, with possible communication with the pleural space.
Figure 2. CT scan of the chest showed empyema with LLL pneumonia and air in the mediastinum.
Figure 3. Three- dimensional CT scan of the chest showed fistulous tract close to the gastroesophageal junction.
A 51 year old woman with rheumatoid arthritis, diabetes mellitus and gastroesophageal reflux disease had a transoral incisionless fundoplication for a hiatal hernia 6 months before admission. She presented with left lower lobe pneumonia and empyema. The esophagram showed a fistulous tract communicating with the pleural space (Figure 1). CT scan of the chest also showed air in the mediastinum (Figure 2) as well a fistulous tract in the three dimensional reconstruction (Figure 3). Esophagogastroduodenoscopy (EGD) showed an esophageal defect 5 cm above the gastroesophageal junction. An esophageal stent was placed with success.
Mohammed Alzoubaidi MD, Carmen Luraschi Monjagatta MD
Department of Pulmonary and Critical Care Medicine.
University of Arizona
Tucson, AZ
Referenc as: Alzoubaidi M, Luraschi-Monjagatta C. Medical image of the week: esophageal-pleural fistula. Southwest J Pulm Criti Care. 2014;8(3):179-80. doi: http://dx.doi.org/10.13175/swjpcc019-14 PDF